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BUSINESS CERT TICATE tt 09 <br /> IIIE COMMONIVEALTLI OFNIASSACIIUSETM <br /> TO 17/N OF MASHPFE <br /> DFlTL' —na <br /> Expn'ation Date: December 31, 2013. <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undei�iereby declare(s) that a business under the title of <br /> DBA La"_� _��D� isconductedat <br /> Business Location: p v 11/1 l�(.� iz ii! <br /> Business Mailing Address: aAkok <br /> Business Type: e aA �< '(,Z,/ iness'Pelephnne:_ � 53`I I� -� 1 <br /> by the following named persons 111 <br /> FULL MF )ADEN E <br /> � eon e Liman <br /> Home Phone: 5� -y <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have 51ed all state tax returns and paid all state <br /> *-, 2,,,.eqtmed under law.e of authorized agent *Signature of authorized agent <br /> q 7�- -1 a 51195 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> \ p In case of emergency <br /> NAME: � ayi/A � N1lAM TELEPHONE NUMBER [ � - <br /> Alarm Company: .. <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension ol ievocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. - <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> it tic. <br /> A certificate issued in accordance with this section shall be in force and effect for four years Goo the date of issue and shall be renewed <br /> each four ye(zw <br /> s thereafter so long as such usiness shall be conducted and shall lapse and be void unless so renewed <br /> Signed _ / <br /> • / Notary Public <br /> SEAL <br /> Commission Expires: <br />